Proxy access to online patient records
With new online services, practices are now facing challenges around proxy access rights and limitations. Proxy access refers to access to online services by somebody acting on behalf of the patient
Competent Adults - as per the Mental Capacity Act 2005, patients over the age of 16 are presumed to have capacity and should be given appropriate access to online services.
Children - Guidance published by the RCGP and NHS England makes it clear parents and guardians only have access rights up until the age of 11. However, there may be exceptions to this on a case-by-case basis. Please see the link below.
Proxy access guidance for general practice - RCGP Online Learning
11-16 years - Proxy access should be deactivated when a patient turns 11. Those who can make independent and informed decisions should be actively involved in decisions about who can access their information - this may result in their proxy having access to make appointments and order repeat scripts only
16-18 years - Where a child 16-18 appears to lack the capacity to manage their healthcare needs, GP’s may decide proxy access should remain with the parents/guardian.
Parental responsibility - It is common for practices to be caught up between estranged parents. Where access is requested by an estranged parent the same process as above should be followed. If the child lacks capacity the practice must clarify and seek evidence of parental responsibility. It is always recommended to encourage a collaborative approach with both parents where possible. If one parent has proxy access, it is recommended they be notified of the other’s request, however, they do not have the right to oppose it. However, if the requesting parent has had their parental responsibility revoked or access would be detrimental to the child, the other parent can provide evidence of this. The final decision would be down to the GP along with what information they would be given access to.
Adult patients who lack capacity - Where a patient has a Lasting Power of Attorney (LPA) or a deputyship has been ordered by the court of protection, proxy access can be provided to the nominated person. Where these arrangements do not exist, next of kin or carers may request proxy access. It is the GP’s responsibility to ensure access is only given where necessary and it is in the patient’s best interests.
This article is a summary of some of the points detailed in the RCGP/NHS England Guidance.